I thought I'd take the suggestion of a couple of folks and start to document, in a single thread, my PCa journey. I'll start by saying I served 27 years in the USAF (Security Forces) retiring in 2003 off the general staff in the Pentagon. I now work for a large defense contractor in the DC area. I have a wonderful wife and three great kids, two cats and two dogs (all rescued). I believe everything in life can, somehow, be related to either football (that's American football) or Star Trek. I enjoy old movies, hence the title of my thread which is a rip-off of Dr. Strangelove, and collect WWII M1 Garands. I have ups and downs, just like everyone else and thought, until recently, I was somewhat incinvible. So, with all that said, it's time to start the path to recovery! P.S. Forgive me if I tend to ramble, I never seem to be at a loss for words
November 8, 2009: Well, looks like I get to join the PCa club! After watching FloMax commercials for a year I finally decided that the low flow was me and went for a general checkup in August in order to get a prescription - it NEVER entered my mind, as a 52 year old healthy man, that I could have cancer. My Doctor did a routine blood test, and a DRE that confirmed the inflamation. He questioned me about symptons, nope, no back pain, blood in the urine, etc. A week later I received a call asking me to come back in to discuss a higher than normal PSA. In I went and found my PSA was 8.7. Even then I wasn't really worried since a number of factors could affect the test, but I was scheduled to visit a Urologist a couple of weeks later in their Stafford offices. I had to cancel that appointment due to work and was rescheduled. When I met with the Urologist, he expalined the PSA to me and that there was another indicator in my blood serum that had him concerned and that I should have another DRE and a biopsy. He did the DRE in the office and told me that there were some hard or calcified spots that warranted additional testing through a biopsy. Okay - starting to get a bit worried now. I stopped by the wellness pharmacy and picked up a double pack of Fleets (enema) which is administered the morning of the biopsy. The wife laughed at me when I asked for her "help" and told me I was on my own! Not really an issue administering the enema, but I can say that it did work and it did work quickly! I went to the main Urology Associates of Fredericksburg office for the biopsy. Clothes off, up on the examining table, onto my side with the knees up. Ultrasound goes in and then a few locals. Then the fun begins with the first needle ( the local hadn't quite taken effect yet - boy, that gets your attention), then 11 more needles (good thing I researched the procedure ahead of time since the Doctor did not tell me what the procedure entails or how the procedure is performed). What a mental journey that was with the nurse "cocking" the needle each time and me there thinking, okay, only 11 more to go, only 10 to go, only 9 to go, etc! It doesn't hurt after that first one, but it's still in your head! I waited two weeks for the results and had my follow on consultation November 3rd. My Urologist was professional and told me there were malignancies and that I had cancer. Okay - that got my attention. Of 12 cores sampled, I had cancer in 4 with a Gleason of 3+3=6 (1 of 3 cores involving 2% in the right apex, 1 of three cores involving 20% in the right mid, and 2 of 3 cores involving 15% in the right base - forget to ask what stage though). I'm a pragmatic person, so I may have taken the Doctor a bit by surprise since I basically accepted the results and asked about the next steps. The medical assistant scheduled me for a CT scan, which I just completed on the 6th (gave me a great disc with hundreds of pictures, too bad I don't know what I'm looking at!) and I have a bone scan scheduled for the 13th. Then I'll have a follow-on consultation on the 1st of December.
So, lots of reading and research to do so the wife and I can decide on a treatment. Lots of questions, but most will wait until the consult with the Urologist on the 1st. While I want this out of me, it may be early enough where the differing treatments have the same level of success (need to get that stage form the Doc). A couple of inital questions for the audience though:
1. If your in the NoVA area, drop me an e-mail or leave a reply since I will probably want a good recommendation for a Doctor. While I appreciate the Urologist I have now, with all the professionals in this area, it would be short-sighted to overlook all options.
2. Do all Urologists have Frankenstein like hands? Can't we get people with little baby fingers?
Hints, tips and advice always welcome!
November 6, 2009: I had my CT scan at Medical Imaging of North Stafford. I had already picked up my barium sulfate drinks (2 - I selected the Berry flavor) and took them at 2 and 1 hour before the test. The stuff is horrible, no matter the flavor. It took me 10 minutes to drink each. Note to self - the internet is your friend and I should have done my research - the sulfate is designed to go through you! I got to the windwo and told the ladies I couldn't hold that stuff in any longer. They chuckled and commented that it's supposed to and that the Doctor should have told me. Off to the men's room where I spent 17 minutes "evacuating!" I guess that's why they tell you to be a half an hour early. The first tech inserted the catheter in my arm and dropped me off with the tech who did the scan. She positioned on the table and told me that she'd be injecting me with contrast solution and that I'd have a wonderful feeling of warmth and not to worry, I wouldn't really pee on myself. She asked me a few questions then the scan was completed. Off to the waiting room where I awaitied the CD with the scan itself. 15 minutes later I had a disk in hand with hundreds of images of my pelvic area. Back home for some research on what the images should look like - I'm not a Doctor, but I did stay in a Holiday Inn last night - useless thought though - let's wait and hear what the doctor has to say.
November 8, 2009: I ordered six books through the HealingWell site that I thought would be helpful as I try to decide what treatment I should undertake. I ordered:
A Primer on Prostate Cancer - The Empowered Patient's Guide by Stephen Strum
Give Yourself a Second Opinion - Dr. Patrick Walsh's Guide to Surviving Prostate Cancer by Patrick Walsh
What Your Doctor May Not Tell You about Prostate Cancer by Glenn Bubley
Dr. Peter Scardino's Prostate Book by Peter Scardino
The Prostate Cancer Treatment Book by Peter Grimm
Saving Your Sex Life by John Mulhall and,
I received the Complete Guide to Prostate Cancer by Peter Bostwick from my Urologist
As of this update, I've completed the book by Bubley and am 3/4 of the way done with Walsh's book.
November 13, 2009: Okay, time for the Bone Scan. Off to Mary Washington Hospital in Fredericksburg for the scan. Checked in at the desk and answered some questions, filled out the obigitory and ubiguitous forms, then sat down to notice I was, with one exception, the youngest in the queue. I was escorted into the treatment room where Dimetri shot a small dose of the radioactive tracer into me and asked I come back in 2 1/2 hours. Off the NTW to have the tires rotated and balanced. I swear there were only two people in the place and it took an hour and a half to get them done. Anyways, it wasn't like I had anything else to do, so I got some good reading time in. I went back in for the scan and it too was a pretty simple procedure - layback and don't move. The scan was over in about 35 minutes, then it was off to the waiting room again to request a copy of the scan and the dictated results. I was able to pick them up on the 14th and the results were favorable: "There is no evidence of focal abnormal accumulation to suggest osseous matastic disease." The scan was also compared to the CT to determine these results.
November 15, 2009: I decided that my lifestyle needs to change a bit so I can be ready to fight this regardless of how early my detection was and the seemingly favorable outcome I should expect given early detection. I started on a multi-vitamin that targets prostate health with certain increased dosages of seemingly helpful vitamins such as D3. I'll also be drinking more water and juices (such as pomegranate) even if that's only a marginal step. I asked the wife to help by forcing me to reduce my red meat intake and yes, I may actually even eat my brocolli now. More exercise too, so it's time to get the equipment in the basement dusted off and ready again - I'd like to lose 20lbs by the 1st of the year as well as tone up again so I reduce my BMI and flabbyness.
I'm really leaning towards surgery at this point, mostly due my age, the reading I've done so far, the ability to have options for salavage if needed and the supposed side effects of other treatments, such as seeds and the research indicating, over time, the occurrance of incontience and impotence increases. I have to say that I'm also surprised that long-term study data just doesn't seem to be there on some of the other therapies, hence my current rationale for surgery. I'll continue to write more though as I mature my research.
I've completed Bubley's book and found it to be an informative resource that lists many differing topics/issues in a single volume. I believe, through research, you will eventually find everything the book covers, but having it in one resource is helpful.
I've completed Walsh's book and found it to be an excellent resource. While Walsh is clearly an advocate of surgery, he covers, with details, a wide range of issues associated with PCa that provide additional research and data points. He covers Johns Hopkins studies that are helpful but that also point our that we are still learning about this disease and its treatment. Two thumbs up for this book.
November 21, 2009:
I completed Scardino's book and found it to also be an excellent resource. Now that I'm doing more and more research, some of the information presented I found in other research or references, but I enjoyed the fact that the Doctor explained all the treatment options along with their side effects.
I completed Grimm's book on treatment for PCa. I liked the format of the book where he presented many topics using a question and answer style so it reads like a patient asking the questions of their Doctor.
I just started Strum's book and appreciate the fact that there are charts and pictures, all in color, which adds to the discussions in only the way a visual can.
While all the books are tending to run together in the information presented, each has their positives and each presents information in a slightly differnt manner which adds to the research on options we all have to make.
I've also researched some alternatives for staying healthy long-term, as well as what to do short-term before I make my treatment decision. I decided to stop taking a multi-vitamin because of the amount of B vitamins, including Folic Acid. Reports are indicating that Folic is like gas to the PCa fire, so I'm stopping vitamins. I will continue on 1000U of D-3 and I've added an Omega-3 since, as a polyunsaturated, it helps control the bad fats (saturated) in the system. I added some Flaxseed to my routine and will also look into soy. I am continuing to take FloMax and Avodart so that I keep my prostate at a reduced volume so removal will be easier and potentially less invasive to surrounding tissue.
December 1, 2009:
I had my final meeting with my urologist today to go over my test results one more time. I asked about the biopsy results and he's confident (absent any other pathological results) that I'm in a good position for long term recovery. We discussed my two preferred treatment options, surgery and seeds. The Doctor said that if it were him, given my PSA, Gleason, age and biopsy, he'd select surgery because of the long term survivability and salavage options. He said seeds were also an option, but that the long-term studies do not have as much data supporting long-term results and that incontinence and impotence seem to get progressively worse with time. His opinion was radiation (including seeds) are a good option, but a better one for people more advanced in age. We talked briefly about ProstRcision out of RCOG in Georgia - he was aware of the procedure and quite strong about the presentation of the data to favor their practice. While I used the word "skewed," he used the word "voodoo!" I asked about nerve sparing considering the location of my cancer and he said he'd recommend only sparing one side. We both discussed our frustration with the lack of current information and that it seems data and studies date to 2004 and before. With new studies being released almost weekly, it seems those coming after me may have better information on which to base their decisions. We completed our discussions and I set an appointment with a Doctor in the practice who does robotic.
POST IS GETTING A BIT LONG SO UPDATES WILL FOLLOW FURTHER DOWN IN THE THREAD.